A 45-year (1935-79) retrospective study of essential tremor based on original medical records on residents of Rochester, Minnesota, is presented. The age and sex adjusted incidence for the most recent 15 year period was 23.7 per 100 000 for US white population. The prevalence rate, age and sex adjusted to 1970 US white population on January 1, 1979 was estimated at 305.6 per 100 000. Survival after diagnosis of essential tremor is comparable to age and sex matched population of West North Central United States. Mean age at diagnosis was 58 (range 2-96) years. Age adjusted annual incidence rate was not different in males (18.3/100 000) and females (17.1/100 000). Functional handicap was reported by four (1.5%) of the 266 incidence cases in school, 13 (5%) cases at work and five cases (2%) retired prematurely. Excessive use of alcohol was noted in 16% and 6% were diagnosed as alcoholic. Torticollis was diagnosed in 3% cases and an additional diagnosis of Parkinson's disease after the index date was made in 2% of incidence cases. Subsequent emergence of Parkinsonism was regarded as incidental. Diagnosis of hypertension was made at some time in 30% of incidence cases during the period (mean 37 years) for which the medical records were available. Risk of hypertension after onset of essential tremor in the cases was not different from that in a control group.
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